组织细胞肉瘤栓塞引起的大面积肠坏死：一例报告
Massive enteric necrosis caused by histiocytic sarcoma embolism: a case report.
作者信息
Imoto Yoshitaka, Yamadera Masato, Ohno Hiroki, Okamoto Koichi, Kajiwara Yoshiki, Kishi Yoji, Shimazaki Hideyuki, Matsukuma Susumu, Ueno Hideki
机构信息
Department of Surgery, National Defense Medical College, Namiki 3-2, Tokorozawa, Saitama, 359-8513, Japan.
Department of Laboratory Medicine, National Defense Medical College Hospital, National Defense Medical College, Tokorozawa, Saitama, 359-8513, Japan.
出版信息
Surg Case Rep. 2024 Oct 4;10(1):228. doi: 10.1186/s40792-024-02031-4.
BACKGROUND
Histiocytic sarcoma (HS) is a rare disease characterized by the presence of neoplastic histiocytes. We herein report an unusual case of HS that caused massive tumor embolism-related transmural necrosis of the small intestine.
CASE PRESENTATION
A 64-year-old man presented with multiple nodules in the lungs, bone, mediastinum, and subcutaneous tissues that were incidentally detected on preoperative computed tomography for early transverse colon cancer. Approximately two months later, the patient presented with signs of peritoneal irritation suggestive of small intestinal necrosis. Emergency surgery was performed and the necrotic small intestine was resected. Pathological examination revealed small bowel necrosis due to multifocal HS embolism. The postoperative course was uneventful. The patient was unsuccessfully treated with chemotherapy for HS and died 122 days postoperatively.
CONCLUSIONS
HS can cause massive enteric necrosis due to tumor embolism. Clinicians should be aware of this rare presentation of HS.
背景
组织细胞肉瘤（HS）是一种罕见疾病，其特征为存在肿瘤性组织细胞。我们在此报告一例不寻常的HS病例，该病例导致小肠因大量肿瘤栓塞相关的透壁性坏死。
病例介绍
一名64岁男性，术前计算机断层扫描偶然发现其肺部、骨骼、纵隔和皮下组织有多个结节，诊断为早期横结肠癌。大约两个月后，患者出现提示小肠坏死的腹膜刺激征。进行了急诊手术，切除了坏死的小肠。病理检查显示多灶性HS栓塞导致小肠坏死。术后过程顺利。患者接受HS化疗未成功，术后122天死亡。
结论
HS可因肿瘤栓塞导致大量肠道坏死。临床医生应了解HS的这种罕见表现。
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